Closed Rhinoplasty in Korea: Correcting a Contracted and Deviated Nose with Columella Lengthening

Overcoming the Challenges of a Contracted and Deviated Nose

Revision rhinoplasty is widely considered one of the most complex procedures in facial plastic surgery. When a patient presents with a contracted nose—often the result of multiple previous surgeries, infection, or capsular contracture around an implant—the structural integrity of the nose is severely compromised. Coupled with a deviated septum and nostril notching, the surgical challenge requires an exceptional level of skill and precision.

At Noselab Plastic Surgery in Seoul, South Korea, Dr. Chayoung Kang specializes in addressing these exact complexities using advanced closed rhinoplasty techniques. In this case study, we explore how Dr. Kang successfully restored both the function and aesthetics of a severely contracted and deviated nose without any external scarring.

Pre-Operative Assessment: The Patient’s Concerns

The patient visited Noselab Plastic Surgery seeking a solution for a nose that had become significantly deformed following previous rhinoplasty procedures at another clinic. The primary concerns included:

• Severe Contracture: The nose had become shortened and upturned (often referred to as a “piggy nose”), exposing the nostrils excessively.
• Deviated Nose: The nasal bridge and tip were visibly crooked, leading to facial asymmetry and breathing difficulties.
• Short Columella & Nostril Notching: The tissue between the nostrils (columella) was retracted, and the alar rims exhibited notching, creating an unnatural, pinched appearance.

Dr. Chayoung Kang’s Surgical Plan

As a renowned expert in closed rhinoplasty, Dr. Kang designed a comprehensive surgical plan that would address all of the patient’s concerns through incisions made entirely inside the nostrils. This approach ensures no visible scarring on the columella, which is especially crucial for patients whose skin and tissues are already compromised from previous surgeries.

The surgical goals included:

1. Contracture Release: Carefully dissecting and releasing the internal scar tissue to allow the nasal skin to stretch and lengthen.
2. Deviation Correction: Reconstructing the nasal septum to straighten the nose and improve airflow.
3. Columella Lengthening: Using autologous cartilage to extend and project the columella downward, restoring a natural nasal tip angle.
4. Notching Correction: Lowering the retracted alar rims to correct the nostril notching and reduce nostril visibility.

The Procedure and Results

During the surgery, Dr. Kang meticulously released the capsular contracture. By utilizing the closed rhinoplasty approach, he preserved the blood supply to the nasal tip, which promotes faster healing and reduces the risk of tissue necrosis. Autologous cartilage was utilized to provide robust structural support for the columella lengthening, ensuring the nose would not contract again in the future. Finally, specialized grafting techniques were applied to the alar rims to correct the notching.

The post-operative results were transformative. The patient’s nose was successfully lengthened, eliminating the upturned appearance. The deviation was fully corrected, resulting in a straight, harmonious nasal bridge. Furthermore, the columella lengthening and notching correction created beautifully balanced nostrils. Most importantly, all of this was achieved with zero external scarring.

Why Choose Noselab Plastic Surgery?

Correcting a contracted and deviated nose requires a surgeon with deep anatomical knowledge and extensive experience. Dr. Chayoung Kang’s mastery of closed rhinoplasty allows him to perform complex reconstructions that many surgeons would only attempt via an open approach.